Presidential Platform: Non-Governmental Health Care Insurance for Everyone

This is not the entire package, but a synopsis of that package: a working pilot.  Nevertheless, the following is to be a strong guideline.  Additionally, while no one is required to have health care insurance, every legal U. S. citizen is to be offered health care insurance at a rate that is achievable for people at every income level.  There is to be no governmental monetary involvement.  The government may be used to: (1) help create a list of job titles, or verify annual gross incomes; and, (2) to ensure that no one, or any married couple, is drawing insurance from two health care insurance companies (Spousal Coordination of Benefits Policy Form).  These are the only two places in which the governmental can and shall be involved. Insurance companies are driven to offer lower premiums, to offer lower co-pays, and to provide better coverage for everyone through tax incentives which create competition. Insurance companies, while they keep a reserve of money for emergency situations, are to be non-profit, a maneuver that will also help in reducing premiums and co-pay levels.

For purposes of discussion, the term group is to mean a list of legal U.S. citizens who have in common their ability to gain insurance together.  All people, having reached the age of 18 years, with the lone exception of students finishing their k-12 education and those involved in furthering their education, are to be grouped.  All groups may be constructed either by (1) employment title or by (2) gross annual income, but not both.  A choice by someone has to be made concerning which method will be used to gather members of groups.  Nevertheless, those who are not employed, due to chronic illness of any type, are to be grouped together.  This also mean that people with pre-existing health conditions must be insured and cannot be refused insurance and care by any health care insurance company.  Those who are capable of employment, but are not employed, for any reason, are to be grouped together.  Students, who remain involved with their college education, may remain under their parent's/s' health care program until age 32, or until they graduate from an educational institution during the calendar year of their 32nd year in which their education is finalized, and the student must be in a degree-achieving program and actively achieving that degree.  Men, at 65 or after, may join Medicare.  Women after age 62 may join Medicare.  Retired people may stay with their regular insurer or they may opt for Medicare.  Retired folk may opt for their group's pensioners' full health care insurance or, if they join Medicare, may opt for their group's pensioners' supplemental insurance.  Folk, who retire before 62/65, may join their group's pensioner's insurance.

A law must be passed that permits groups, gathered either by job title or by gross annual income, to cross state borders in order to gain members and, therefore, insurance policies to also cross state borders as well.  It would also be helpful if tort reform were enacted and passed, being extremely mindful of both sides of the equation.  Tort reform isn't one single idea or law.  Instead, it's a collection of ideas and laws designed to change the way our civil justice system works.  While each tort reform law is different, they all share one or more of the following goals:

  • To make it more difficult for injured people to file a lawsuit.
  • To make it more difficult for injured people to obtain a jury trial.
  • To place limits on the amount of money injured people receive in a lawsuit.

Many people refer to it as tort "reform" because they don't believe that the proposed laws will actually reform the system, but will instead shift the balance of the scales of justice.  Others call it tort deform for the same reason.  For example, the web site Tortdeform.com is very critical of tort reform measures.  (http://www.whatistortreform.com/)

For purposes of phrase definition, the phrase desired number refers to the number of people required within a group to reduce the group's health care insurance premiums to an amount that is not excessive for that group of insured people to pay monthly and for their co-pays to not be excessive.  When these groups reach a desired number in membership, they will qualify for group rate co-pays.  If the desired number is reached within a state's borders, then there is no reason to gather members from any other state.  For instance, educators might have a populace large enough to reach the desired number within their state, but there might not be a large enough populace of saw mill workers to reach the desired number within a state.

Groups whose members are selected because of job title within a state may combine in order to achieve the desired number if the groups involved are related.  For instance, waitresses and waiters would be one group.  Dish washers would be one group.  Cooks/chefs would be one group.  However, these same groups could also combine.  Gas station mechanics, car dealership mechanics, and truck mechanics within one state could combine; however, if their number still did not attain the desired number, they could join the same joined group in a neighboring state.  Landscape workers can unite with lawn mowing services and nursery workers.  An alternative to this method of grouping members would be to group members by their gross annual income.  Everyone must belong to a group; however, individuals may opt to not purchase health care at the annual enrollment period at their own peril financially and physically.  No hospital will be required to offer their services to patients who do not have health care insurance.

People who are physically able to work either in or out of their homes, but refuse to do so, will receive no financial aid of any type or kind from any governmental agency.   They will receive no health care insurance.  No hospital is required to service them.  For those who are willing to work but cannot find work, work will be found for them and the person must accept the position offered or one of the positions offered.  If a person is gainfully employed, but does not earn enough money to afford health care insurance, as determined by governmental financial agencies, health care will be provided for them by the health care insurance companies at a lowered rate or at no cost. 

People, who for health reasons, cannot work will comprise their own group.  They will receive all the help from governmental agencies to which they are entitled.  Their health care is free and they may individually select the health care insurance company of their choice.

People who are paying for their health insurance will have added to their premium a stipend which is the insured member's contribution to those less fortunate.  As such, this stipend is tax deductable.  Once the federal taxable income is ascertained, the year's annual stipend is to be deducted resulting in the net taxable income, that net dollar amount used to calculate federal taxes.

There are perhaps 162 Health care insurance companies in the USA and they are to be invited to gain the attention of every group within every state thus providing for competition among the insurance companies for the lowest priced premiums and co-pays for the most coverage.

Tax incentives are offered to the health care insurance companies.  On the federal tax forms, each company's tax burden is reduced by a percentage.  The percentage is based upon the number of states in which their insurance is offered. If there insurance is offered in only one state, their burden is reduced by 0.0196, or 1.96%, or 1/51.  Within each state, the tax burden would be reduced by the number of groups covered as compared to the total number of groups within the state.  That is, if the state contains 85 groups and the insurance company provides insurance to one of the 85 groups, their tax burden is reduced by 1/85, or 0.0118, or 1.18%.  A company providing health care insurance to 35 of those 85 groups would reduce their state tax burden by 35/85, or 7/17, or 0.14118, or 14.118%.  The drive to lower the company's tax burden would cause competition and, therefore, lower premiums and lower co-pays in addition to creating alternative plans and their structure.

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I will have to reread this a few times before I can fully contribute to the forum.  I see a number of great ideas and several that I fear will never fly.  I will expand on this after thinking it over in greater detail.

Mary Gomez WRITES: VIA MESSAGE:

I AM PERSONALLY INTERESTED IN HEALTH SAVINGS ACCOUNTS.  IF SOMEONE IS RELATIVELY HEALTHY OVERALL, HAS PRETTY GOOD, CLEAN YEARLY PHYSICALS, HE OR SHE SHOULD BE ABLE TO CARRY THE MONEY OVER TO THE NEXT YEAR AND SO ON.  I REALIZE THAT THERE MAY BE TIMES WHEN SOMEONE MAY REQUIRE SURGERY, SO WHY SHOULDNT THAT PERSON BE ABLE TO PURCHASE A LOW COST PLAN TO COVER ONLY MAJOR MEDICAL EXPENSES. THIS PLAN MAY OR MAY NOT EVER BE USED, BUT SHOULD BE AVAILABLE IN ADDITION TO A HSA. PRE-EXISTING CONDITIONS SHOULD BE COVERED, AND ONE SHOULD BE ABLE TO CARRY THE INSURANCE TO OTHER STATES.  I DONT THINK WE NEED THE GOVT INVOLVED IN ANY PART OF OUR HEALTHCARE, IT SHOULD ALL BE HANDLED IN THE PRIVATE SECTOR.

only problem is:  medical error has become the #1 cause of death in the United States and the legal system is not equipped to deal with this fact.  I believe in Tort laws .  I believe they are the only thing that keeps from "medical experiments gone wrong" and other medical tragedies from becoming reality to the masses.  It is already hard to get any case through the current system that has validity due to the costs and rules that are placed upon the injured.  I do not believe in medical associations (paid for/into by the doctors to protect themselves, not their patients); though advertised as an advantage to patients.  I believe there should be a separation of insurance companies and medical facilities  - which by natural process would alleviate most of the injustice; i.e. - that they cannot be owned by the same investors.  I believe there is too much advertising of pharmaceuticals and every time a new drug is advertised, it is closely followed by some class-action attorneys advertisements of what the drugs advertised has adversely caused.  But:  I believe that class-action lawsuits are not the most effective way to keep these wrongs from happening; it is only that current laws have made it impossible for anything other than to financially be available.  Most often only the attorneys of the class actions recover benefit other than minor as most all (the system) are settled:  attorneys get their hourly costs and the plaintiffs get less than had they sued using Tort laws.  I believe "Class Actions" are an unfortunate outcome of a medical/legal system that has failed.

I believe in free market healthcare for all adults except retirees and children under the age of 18 and Veterans.  Senior citizens who paid into government programs for their retirement should get the full benefit of what they paid into either in a lump sum back to them with interest and therefor have enough funds to continue their own health coverage if they choose to do so; or receive the full medical care they deserve and have already paid for.  I believe all government workers too should pay into their own medical insurance while employed and for their retirements.  It is a burden on other citizens to pay their benefits free of charge to them and is breaking America.  I believe it would cost no more than the current union dues they pay and their "benefit" would be equal to or greater than what the union benefits achieve.  I understand that government employees are "paying union dues" therefore, they have already paid they think for their benefits; but it is more expensive for them and taxpayers to pay a third party that is unnecessary - the union leaders are the benefactors, not the employees. ; and this would also fix the "employed for life" of crappy workers allowing those who are really good/honest to achieve better pay increases and the like...   I believe all children under the age of 18 should be covered in cases of their parents have not been responsible and cannot provide for the children they brought into the world, but their parents are not covered  - and only for American citizens; no immigrants - legal or not - receive health coverage until they are citizens whether child or adult unless that coverage is supplied by an employer via a valid work permit.  I believe this would "fix" most financial stresses on the system.  I believe those Americans who served our country in the military should also be covered for life along with their spouses/children; and "really good" medical care.  I know the VA has a large enough budget but our current government(s) - not just Obama's admin but also prior... has used the bulk of the budget for medical care of veterans instead for research and development for profit.  That is where that money is going to, not to the care of soldiers.  And most of the projects/funding being used for specific research has not a whole lot to do with specific care of veterans; if that were the case, then there could be seen a correlation at least to the R&D,

I believe medical care is not a one size fits all concept and should not be utilized to control a population via statistical majorities and that ethics and disclosure is healthier for the country than socio-medical experimentation. 

Forgot:  the only government employees who should get medical benefits at no cost (be unionized so that they do have the benefits they need) are first responders; i.e. - law enforcement and fire and paramedics...  they put their lives on the line and have hectic/personal life altering schedules...  they are the only government workers who actually need the unions to protect them from being totally abused; and by nature of their work(s) absolutely must have medical benefits at no costs to them as part of their employments.

My Thoughts on health insurance very well may offend people here. 

Health Care is a Commodity/Service , and not a "RIGHT" as understood in our Constitution. 

Modern Health insurance went from covering what most people needed to covering everything including self inflicted health problems. I could list some but you should be smart enough to figure that out.

Reading the  IDC-10  Manual of coding for medical treatment will give you an idea of just how massive the insurance regulations have become.

IF you could track every penny spent on so called health care you might be surprised where the money goes.  A simple vaginal birth now costs  thousands . 

The biggest issue is that we have given up personal responsibility and transferred that responsibility to the medical system and they charge a very high price for that!

However do not worry!  you won't have any health care when our economy crashes!

Your health care will be what you can provide for yourself personally ! 

You may think I an crazy but TAKE A LOOK at Gurald Celente's thoughts on our economy and future !

http://www.trendsresearch.com/

Comments on medical industry reforms...

Tort reform... Should not make it more difficult to file... it should limit liability to actual damages and costs.  It should restrict attorney compensation and provide a clear definition and penalties for filing 'frivolous' actions. We should not limit the ability to file... just the compensation formulas and add serious penalties for frivolous actions.

Non-Profits... Health Care Cooperatives and Mutual Insurance groups owned by the policy holders...  as the primary medical insurance providers is a good Idea.  However, one can not simply waive a magic wand to create such organizations.  The reserves needed to start up such groups would be monumental. Hence, it may require some form of temporary underwriting by the Government, until these Mutual/non-profit insurance companies can establish the reserves needed to remain solvent and operating.

Regulatory limits on profits... earned by 'for profit' health insurance companies... should be established. No more gouging ... limiting profits by establishing rates was one function of State Insurance Commissions in the past but these institutions are being abused and over the years they have become worthless as oversight institutions. Limits on profits must be established if premiums are to be kept low; while providing a reasonable return on the owners investment. Limiting the PERCENTAGE of profit earned will not destroy competition or kill the insurance industry.  Insurance companies in the US, at one time, were mainly MUTUAL companies.  Mutual Insurance Companies were owned by the insured and were run for their benefit. Profits in a Mutual Insurance company were returned to the policy holders thru lower policy premiums.  That should be a goal for regulating Medical Insurance Companies.

Interstate Competition... definitely should be allowed.  Policies should be standardized, coverage disclosures made simple to understand, based on national standardized disclosures, and the regulatory taxes and reserves required will need to be standardize and regulated by Federal Regulation... Every insurance company must operates under the same tax and reserve standards if there is to be universal access and competition for interstate insurance.

Taxes on Insurance companies... Federal and State taxes on insurance companies should be standardized,  to facilitate interstate competition and to lower the overall taxes on health insurance companies... this will translate into lower premiums. Your ideas on using Tax incentives to increase multi-state completion is a good idea and should also include standard ranges for State Taxations... ie a flexible rate for States, capped by Federal law.

Reduced administrative costs and regulatory burdens... Standardizing claim process at the federal level will greatly stream line the claims process. The costs associated with such processing is very high today.  Producing a SINGLE standardized national claims process for all medical insurance claims is essential to reducing costs and lowering premiums. 

Medical Records and access by medical practitioners... We must establish a single standard for maintaining medical records. A system designed to provide equal access to a patients records by all hospitals and practitioners NO MATTER WERE FILED.  The goal is to permit any medical practitioner or facility,  legal access, to all medical tests and records for any patient in the system.

No more Proprietary records...  Proprietary records systems often double the costs to the patient whenever they transfer, switch or move providers.  The proprietary records system was created to keep patients associated with the current provider and too make it difficult and expensive for them to change providers.  We must eliminate the concept that the medial provider has a proprietary legal claim on records, tests and procedures, paid for by patients.  We must create a National, patient oriented, proprietary access, to all records by any licensed medical agent. Of course, this will take several years to implement and phase in... we can use tax incentives or even grants too speed up implementation.  The costs savings should be monumental and result in dramatically reduced premiums. This single change would also result in better medical care and outcomes for patients.

Comparing fees for service... establish a standard table for fees for medical service using the current rates for services and fees paid by Medicare as the base fee... Require hospitals and all practitioners to publish their fees for similar services in terms of a percentage of that base system: 130% or 90% of the base fee etc.  That will provide patients with a relatively simple and quick reference system, too compare costs, when deciding where to be treated. The idea here is to provide a STANDARDIZE system to compare medical costs between different medical practitioners and facilities.  Not a perfect comparison method but certainly better than no system or a very convoluted and complicated system.  If one facility has fees for services ranging between o% and 110% of Medicare fees and another 120% to 200% one may quickly see which is more expensive... then it becomes a matter of which provides better service and is it worth the costs?

I have other ideas but this should be a start...

 

 

My most important contribution to American, civilian health care, [I'm VA] is privately owned, cross-border competition.  The ONLY problem with the system our dear leader destroyed was no competition.  No one can tell me that there wouldn't be good policies offered at competitive prices if I could go to New Jersey or Florida or...wherever to get automobile, house or health insurance!!!

Illnesses start with "that's not my job", "that's not my responsibility", etc ...and that's a BIG union ...then the "best" of them screwup the little to nothing they do then "blame the absent" and make great profits doing so ...and that's big business and "great" politics ...the poor and sick huddled masses can do nothing but follow ...the cycles culminate with most in demand and lucrative jobs being for doctors, lawyers, judges and the few cowards in militarized police, because nobody trusts nobody with a firearm.

Solutions are in least busy people being doctors and militias on patrol ...lawyers and judges are out of work and eventually only in the vocabulary of history books.
I believe there must be mandatory drug tests (which are only done by medical labs or offices) for anyone receiving welfare. Additional welfare money is given for each additional baby born. This should NOT be an incentive to keep having more babies. Personally, I want to see term limits for welfare, five years or less and then you are OUT of the program, excerpt for the mentally handicapped, disabled Veterans. Being fat or anxious, or depressed etc is not a reason to NOT work. Under Roosevelt, Americans worked for government work forces (the CCC - Civil Conservation Corps, and the WPA are just two of them), there was no welfare. People without jobs were given jobs all over the U.S. Sitting home doing nothing but collecting Welfare & food stamps is ridiculous and needs to be stopped. If you don't show up for your work program then you don't get paid for that day.

Unfortunately, Lewana, what you are being shielded from seeing in America today is the liberal progressive civilian army that our dear leader spoke of being larger and better paid than our military.  Drugs and insanity are well controlled by evil, and a leader they worship and would die for. It's not just the race factor, but all the goodies that are being re-distributed from American workers to the off-shoots of ACORN; and now the Latino and Mideast Muslims and other demoncraps [in training] who are flooding our border with more force than our brave soldiers at the beaches of Normandy.

Exactly... this is an invasion.  1500/day is 45,000 per month.  That is the equivelant of 3 combat divisions and their support troops... a light combat Corps.  Need I remind folks that the Marxist in Africa and Central America regularly use children as para-military. These children are not raised in a culture of peace... Guatemala, Hounduras, Nicaragua, and Mexico are all burdend with serous poverty, disease and cultures of VIOLENCE.

These children are being disbursed across our great country and many of them are gang members, seriously deluded and abused children... whose mental and emotional development are not conducive to non-violent conflict resolution.  We have no way to know which of these children may resort to serious criminal conduct... but we can rest assured that they are more prone to such conduct than our own children.

Give these children a couple of years here and they will be old enough to vote and too engage in massive protests and demands for a Marxist government.  They carry in them the seeds of social destruction and cultural dissolution... the seeds of communism, which have been incubating in them since birth. 

America must return these delinquent children to their places of entry ... to MEXICO. They must be declared citizens of Mexico, of the place of their crossing.  Under the law, it is presumed that those entering from Mexico,  having the ethnicity and language of Mexico's citizens and with no other proof of citizenship, are  citizens of Mexico.  Unless there is verifiable evidence to the contrary... these children are lawfully presumed to be citizens of Mexico.   

Load them up on trains and return them to Mexico... If Mexico refuses their entry.  Load them up on boats and ferry them across the Rio Grand and discharge them on Mexican soil. If that fails ship them and all illegal aliens pending deportation North to the Aleutian Islands... to be interned  until their status is resolved. If we sent all illegal aliens to the Aleutian Islands for internment until their status could be resolved they would stop coming... put them up in military type pow camps. DO NOT RELEASE THEM INTO THE PUBLIC DOMAIN. After all this is an invasion and a war by proxy... thru the use of illegal entry and the principal of 'Reconquista'... just ask La Raza, MECHA and review the claims of the Mexican government that support La Raza and MECHA's claims.

Then, Close the border to all but commercial traffic, send Mexico's ambassador home with a message that they either stop the illegal entry or the border will be permanently sealed from all traffic until they do.

@ Ronald A. Nelson  Col.USA (Ret) 

You made some outstanding points here but the one I like the most is the fact that since they entered through Mexico without proof that they are from any other country, they must be deemed as Mexican and therefore can be returned to Mexico.  End of problem.  Of course Congress could just repeal the 2008 law Bush wrote.

Is there any way to get this post out to the media?  It is the most intelligent perspective I have heard thus far.

Carolan...

The MSM is well aware of the law and its presumption regarding citizenship... they will not push it as it would solve the problem or at least provide a way to put pressure on Mexico to control their border.

What should be done about ALL the illegals being caught and released?  Well they should not be released on their own recognizance and promise to appear, that's for certain. How about transporting them to the Aleutian Islands, for internment in POW like refugee camps, until they can have their hearing. IF we have to support them one way or another and are able to transport them all over the US ... why not to the Aleutian Islands and why not support them like any other illegal or criminal... with austere but humane facilities.

The word can be put out that if you come to America and are caught ... at any time... you will be arrested, processed, shipped to the Aleutian Islands where you will be held in an internment camp, given three meals and a cot ... until you and ... get this one... your Aleutian Island lawyer, attend your immigration hearing for deportation.  Once a deportation order is issued... you will be given a ticket on a freighter ... steerage class... a box of MRE's, one change of under-ware and sent home.

That should discourage anyone from coming illegally to the US... and it should put a real damper on the ACLU lawyers... unless they like long cold and lonely nights.

The facilities on the Aleutian Islands would be easily secured from escape ... being in the middle of nowhere with no way off the Island.  The camps construction would be minimal Theater of Construction (military construction)... with very basic but humane facilities.  Run it like a military post.

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ALERT ALERT

SICK: Leprosy On The Rise In Los Angeles 

Ahh, the joys of open borders and Democrat leadership.

California is not just a public toilet but now there is evidence that leprosy is on the rise in Los Angeles County.

Barack Obama changed US law in 2016 and allowed immigrants with blistering STDs and leprosy to migrate to the US.

Medscape reported:

Leprosy, also known as Hansen’s disease, is rarely seen in the United States, but cases continue to emerge in Los Angeles County, a new report says.

“Hansen’s disease still exists, and we need to educate medical students and physicians,” coauthor Dr. Maria Teresa Ochoa from Keck Medical Center of the University of Southern California, Los Angeles, told Reuters Health by email.

Dr. Ochoa and colleagues identified 187 patients with the disease in a review of medical records from their leprosy clinic spanning 1973 to 2018. Most patients were Latino, originating from Mexico, and they experienced a median delay in diagnosis of more than three years, the team reports JAMA Dermatology, online August 7.

Multibacillary leprosy (MB) cases outnumbered paucibacillary leprosy (PB) cases by nearly eight to one (88.6% vs. 11.4%, respectively), and Latino patients were more likely than non-Latino patients to have MB, as were patients from Central or South America (versus other regions).

Most patients (80.7%) received multidrug therapy, and most (92.6%) received antibiotics for more than two years, especially if they had MB.

Only about half of patients (56.7%) had World Health Organization (WHO) grade 0 disability (no signs or symptoms suggestive of leprosy or disability) at the one-year follow-up, whereas 16.0% had grade 1 disability (loss of protective sensation) and 26.2% had grade 2 disability (visible deformity) at the last follow-up.

Among the patients who lost protective sensation, 87.7% (50/57) did not regain it following therapy.

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